Can Addiction Treatment Fix You, or is it a Scam?

A few days back, Stanton Peele wrote a piece in the Huffington Post about how people quit addictions. Among other things, Stanton points out that most people leave their addictions with no assistance from the treatment system or from 12-step groups. And yes, that applies even to the hardest cases.

What are we to make of all the messages we get from the media, and from professionals as well, about how so and so "needs" treatment? Often, so and so is even said to need a spiritual conversion because "you can't quit an addiction without working the 12 Steps and finding a higher power" (even though millions of people do!). Well, many of those "experts" have a stake (pecuniary for one) in promoting this nonsense. Beyond that, the addiction regime currently in place is still rooted in judgments and attitudes born in the early 20th century - a time when Western culture's dealings with addiction took a turn toward some of the most harmful (and most untenable) beliefs and attitudes about addictions that, so far, humanity has yet to produce.

Let's start by clearing the air: as a historian of addiction I can tell you that if you had a habit in 1890 - be it cocaine, opiates or alcohol - your chances of kicking were about equal to what they are today. Sorry, but all of our combined efforts (12 Steps, abstinence-based intervention, addiction chatter all over the media) haven't made much of an impact on the big picture. You see, overcoming one's bad habits is a natural process, one that has been going on since the dawn of history. It's not easy, so don't get me wrong: addiction is a reality, and at times a tragic reality that keeps people trapped for years. Having been there myself - and as one who still identifies as "PhD crackhead" - I do not wish to belittle anyone's struggles.

Yes, addiction is a reality and not an illusion one can overcome with a simple act of will. But, no, addiction is not so different from other problems: people improve over time, cutting back here or abstaining for a few days there, on a journey of improvement not entirely unlike a fitness routine: nobody can do fifty push-ups right away, and very few addicts up and change it all overnight. Like marriage, school, friendship or a career, recovery is a journey best understood as involving incremental improvements rather than quick fixes (which, by the way, cater to the same mentally that gets someone hooked on dope or booze in the first place).

As I see it, here is the crux of Stanton's message: let's demystify addiction. It's not a supernatural demon to be quelled with hocus-pocus, and it rarely works with a crash-burn-then-see-the-light plot-line best suited to a B-Grade film.

Nothing I have said here should be taken to mean that addiction treatment has no place. We simply need to get realistic about what treatment really is. If you have an addiction, the recovery process is all yours - the treatment system can only tweak a process that is largely independent of its efforts. Still, the "tweak" can indeed be a lifesaver, but more lives would surely be saved if the system got more realistic (and more humble) about what its efforts really accomplish.

And here's the clincher: more lives could surely be saved if more attention were directed at the one's who really need help - these are the people not yet ready to abstain completely, the one's who need help with their efforts to reduce at every step. If these people achieve abstinence in the end, the real cause will have been those initial efforts to curb rather than quit completely. Yet as I write these words, those very efforts are dismissed by the system as useless - a system that prefers to work only with those who are ready for complete abstinence right now. They "help" the ones who probably don't really need their help, and punk off the ones who do.